Impact of chronic rhinosinusitis and endoscopic sinus surgery on bone remodeling of the paranasal sinuses.
BACKGROUND
Osteitis or bone remodeling is one of the distinct radiological findings in chronic rhinosinusitis (CRS). Bone remodeling of the paranasal sinuses can be affected by many factors including age, sex, chronic inflammation, and surgery. The aim of this study was to investigate radiological evidence of mucosal and bone remodeling and to assess the impact of recurrent rhinosinusitis after surgery on remodeling in patients with CRS.


METHODS
Controls (n = 25) and patients with CRS undergoing primary (n = 25) and revision (n = 15) endoscopic sinus surgery (ESS) were included in this study. Bone remodeling of the ethmoid sinus was checked by the presence of new bone formation (NBF) and measurement of bone density (HU). Bone remodeling of the maxillary sinus was measured by the vertical and horizontal lengths at maximal cross-sectioned CT images.


RESULTS
Lund-Mackay scores were significantly increased in the revision ESS group (p = 0.009) and NBF(+) group (p = 0.014). NBF was significantly increased in the revision ESS group compared with the primary ESS group (odds ratio = 0.127; CI, 0.029-0.562; p = 0.006). There was a significant difference in ethmoid bone density among controls, primary, and revision ESS (p = 0.0001). The maximal sizes of the maxillary sinus were significantly decreased in CRS groups when compared with controls (p < 0.05).


CONCLUSIONS
In the revision ESS group, soft tissue and bone remodeling may be greater than in the primary ESS group.
Cho
Seok Hyun
SH
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Sengdong-gu, Seoul, Korea.
Shin
Kwang Soo
KS
Lee
Yong Seop
YS
Jeong
Jin Hyeok
JH
Lee
Seung Hwan
SH
Tae
Kyung
K
Kim
Kyung Rae
KR
D000293:Adolescent; D000328:Adult; D000368:Aged; D016723:Bone Remodeling / Q000502:physiology*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000502:physiology*; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011184:Postoperative Period; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D012220:Rhinitis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012852:Sinusitis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*